UHF established the Medicaid Institute in 2005 to provide information and analyses explaining New York’s Medicaid program, in order to help all stakeholders build a more effective health care system for low-income New Yorkers.
Medicaid provides a broad range of health care services to diverse groups of New Yorkers. The program’s responsibilities include three main roles:
- Providing health insurance to low-income families
- Covering disabled individuals with no other access to services
- Supplementing Medicare for low-income elderly and disabled people
Medicaid covers more than 6 million New Yorkers each year at a total cost of over $60 billion. Between 2009 and 2015 total enrollment increased more than 36 percent, while per member spending on the program decreased by more than 13 percent. More than 75 percent of Medicaid members are enrolled in some form of managed care. Children account for 37 percent of the population, but less than 20 percent of Medicaid expenditures. Members dually eligible for both Medicare and Medicaid make up 13 percent of the total population.
The program is currently going through a substantial shift in how services are provided and paid for. Reforms envisioned by Governor Cuomo’s Medicaid Redesign Team in 2011 have led to a large increase in the number of members and health care services provided by managed care organizations. The state is also implementing an $8 billion Medicaid waiver with the federal government, intended to transform how care is delivered through the Delivery System Reform Incentive Payment (DSRIP) program, and eventually how services are paid for through a roadmap to value-based payment.
Contact: Nathan Myers